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. 2023 Jan 4;18(1):e0266985.
doi: 10.1371/journal.pone.0266985. eCollection 2023.

Acute respiratory distress syndrome after SARS-CoV-2 infection on young adult population: International observational federated study based on electronic health records through the 4CE consortium

Bertrand Moal  1 , Arthur Orieux  2 , Thomas Ferté  3 , Antoine Neuraz  4 , Gabriel A Brat  5 , Paul Avillach  5 , Clara-Lea Bonzel  5 , Tianxi Cai  5 , Kelly Cho  6 , Sébastien Cossin  7 , Romain Griffier  8 , David A Hanauer  9 , Christian Haverkamp  10 , Yuk-Lam Ho  8 , Chuan Hong  5 , Meghan R Hutch  11 , Jeffrey G Klann  12 , Trang T Le  5 , Ne Hooi Will Loh  13 , Yuan Luo  14 , Adeline Makoudjou  15 , Michele Morris  5 , Danielle L Mowery  5 , Karen L Olson  16 , Lav P Patel  14 , Malarkodi J Samayamuthu  5 , Fernando J Sanz Vidorreta  17 , Emily R Schriver  18 , Petra Schubert  19 , Guillaume Verdy  1 , Shyam Visweswaran  5 , Xuan Wang  5 , Griffin M Weber  5 , Zongqi Xia  20 , William Yuan  5 , Harrison G Zhang  5 , Daniela Zöller  21 , Isaac S Kohane  5 ; Consortium for Clinical Characterization of COVID-19 by EHR (4CE); Alexandre Boyer  2 , Vianney Jouhet  8
Affiliations

Acute respiratory distress syndrome after SARS-CoV-2 infection on young adult population: International observational federated study based on electronic health records through the 4CE consortium

Bertrand Moal et al. PLoS One. .

Abstract

Purpose: In young adults (18 to 49 years old), investigation of the acute respiratory distress syndrome (ARDS) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been limited. We evaluated the risk factors and outcomes of ARDS following infection with SARS-CoV-2 in a young adult population.

Methods: A retrospective cohort study was conducted between January 1st, 2020 and February 28th, 2021 using patient-level electronic health records (EHR), across 241 United States hospitals and 43 European hospitals participating in the Consortium for Clinical Characterization of COVID-19 by EHR (4CE). To identify the risk factors associated with ARDS, we compared young patients with and without ARDS through a federated analysis. We further compared the outcomes between young and old patients with ARDS.

Results: Among the 75,377 hospitalized patients with positive SARS-CoV-2 PCR, 1001 young adults presented with ARDS (7.8% of young hospitalized adults). Their mortality rate at 90 days was 16.2% and they presented with a similar complication rate for infection than older adults with ARDS. Peptic ulcer disease, paralysis, obesity, congestive heart failure, valvular disease, diabetes, chronic pulmonary disease and liver disease were associated with a higher risk of ARDS. We described a high prevalence of obesity (53%), hypertension (38%- although not significantly associated with ARDS), and diabetes (32%).

Conclusion: Trough an innovative method, a large international cohort study of young adults developing ARDS after SARS-CoV-2 infection has been gather. It demonstrated the poor outcomes of this population and associated risk factor.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study workflow.
From EHR extraction to ARDS analysis on aggregated data (HS: healthcare system).
Fig 2
Fig 2. Flow chart.
Distribution of patients per group (y.o. = years old).
See this image and copyright information in PMC

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